What Does a Midwife Do That Is Different From a Doctor?

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A master’s degree in nurse-midwifery, one of the highest-paying master’s degrees, can qualify you to provide healthcare to pregnant women. If delivering babies is your dream career, you may wonder whether a master’s in nurse-midwifery degree or a medical degree and obstetrics residency is the right path for you. While midwives provide maternity care services to patients experiencing routine, healthy pregnancies and deliveries that are similar to what a doctor would do, they approach this function from a more holistic perspective and emphasize the emotional support of the mother-to-be.

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Take a More Holistic Approach to Maternity Care

Like doctors, Certified Nurse-Midwives (CNMs) are qualified to provide primary care for mothers-to-be. This role encompasses all of the pregnancy-related care an expecting mother needs.

Throughout pregnancy, a patient should receive regular medical care in the form of prenatal appointments. Even for routine pregnancies with no complications or risk factors, the mother-to-be should be monitored. Often, prenatal appointments include a urine test and a measure of weight and blood pressure. At different points in pregnancy, patients are sent for routine bloodwork, undergo a glucose test to identify gestational diabetes, have their “baby bumps” measured and undergo ultrasound imaging of their growing babies. All of these tests and exams are meant to ensure that both mother and baby are progressing in a healthy way and to identify any complications that could put either one at risk.

While both obstetricians and CNMs perform these functions for their patients, one of the biggest differences between these two types of providers is how they approach maternity care. Generally, physicians have more knowledge of medical conditions and diseases and are trained using a model of diagnosing and treating these conditions. Certified Nurse-Midwives, on the other hand, enter the field with a nursing background and are trained on a model of nursing care. This model tends to be more holistic in nature. For example, when a mother-to-be complains of common pregnancy ailments like nausea, back pain or heartburn, a doctor is more likely to turn to pharmacological treatments. A CNM, on the other hand, is more likely to suggest treatments found in alternative and complementary medicine, such as massage, acupuncture and acupressure.

This holistic approach doesn’t only apply to prenatal care but also to the management of the labor and delivery process. Nurse midwives tend to view childbirth as a natural process, rather than a medicalized one, and to favor following the natural progression of labor over starting medical interventions unnecessarily. This may include, for example, the use of birthing balls, water immersion, relaxation techniques or position changes to help labor progress quicker and with less discomfort. However, women under a nurse midwife’s care in a hospital or birthing center may still choose more traditional methods of pain relief, such as an epidural, during delivery.

Healthcare providers fall on a spectrum from traditional medicine to holistic medicine. A doctor with a D.O. background tends to take a more holistic approach than one with an M.D., and individual providers may put more or less stock in alternative medicine.

Provide More Emotional Support to Mothers During Labor

While it’s important for doctors to have a good bedside manner, their main function in the labor and delivery ward isn’t to provide emotional support for the laboring mother. Instead, their primary goal is simply to get the baby delivered safely. However, childbirth is a difficult endeavor emotionally as well as physically. With their holistic, whole-patient care focus, midwives may be better suited to meeting the emotional needs of a patient in labor.

Generally speaking, expectant mothers who are high-risk or who develop complications during their pregnancy should see an obstetrician, not a midwife. Since medical doctors are more focused on the diagnosis and treatment of disease, they are better suited to manage the more complex medical needs that arise in a complicated or high-risk pregnancy. That said, even if health risks or health conditions keep a patient from choosing a midwife as her primary maternity care provider, she may still have the opportunity to work with a midwife during labor, according to Penn Medicine. This option allows women to choose the support they need during the labor and delivery process, as well as while recovering from the ordeal of childbirth.

A Certified Nurse-Midwife is qualified to deliver babies through unmedicated or medicated vaginal birth, but in the event that a Cesarean section birth is required, the obstetrician – a physician and surgeon – will perform the surgical birth.

The Education and Credentials That Separate a Midwife From a Doctor

Besides the holistic approach that focuses on emotional as well as physical support, what differentiates a midwife from a doctor is largely a matter of credentials. After completing their undergraduate studies, obstetricians go through four years of medical school to earn a medical doctorate (an M.D. or a D.O.), plus another four years of residency. All in all, it takes 12 years to become this type of doctor.

Certified Nurse-Midwives can prepare for their career in a total of seven to eight years. The path to a CNM career includes earning a Bachelor of Science in Nursing (BSN) and gaining at least one year of experience as a registered nurse. The next step is earning a Master of Science in Nursing degree (MSN) or a Doctor of Nursing Practice (DNP) degree in midwifery, which can take anywhere from 18 months to three years.

Patients selecting a provider for their pregnancy should realize that there are different kinds of midwives. CNMs are highly trained advanced practice registered nurses. Certified Professional Midwives have formal clinical training, while lay midwives do not. 

Additional Resources

Why Would I Choose a Midwife Over My Doctor?

Can Midwives Order the Same Tests as Doctors?

Can Midwives Help With Births at a Hospital?